依托孕烯皮埋剂治疗子宫腺肌病的临床效果分析  

Analysis on clinical effect of etonogestrel subdermal implant in treatment of adenomyosis

作　　者：谢宝丽[1] 刘一萍[1] 黄英梅[1] 卢春华 XIE Bao-Li;LIU Yi-Ping;HUANG Ying-Mei(Department of Gynecology,the First People's Hospital of Nanning City,Nanning,Guangxi 530016,China)

机构地区：[1]南宁市第一人民医院妇科,广西南宁530016

出　　处：《中国妇幼保健》2021年第8期1708-1711,共4页Maternal and Child Health Care of China

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z20180667)。

摘　　要：目的观察依托孕烯皮埋剂治疗子宫腺肌病的临床效果。方法选取2018年1月-2019年1月在南宁市第一人民医院妇科就诊,经B超或MRI提示子宫腺肌病,并有月经改变、痛经、子宫增大要求保守治疗的患者60例为研究对象,随机分为观察组和对照组,每组各30例。观察组在月经第1~5天皮下埋植依托孕烯单根皮埋剂,对照组在月经第5~7天宫内放置左炔诺孕酮宫内缓释系统。观察治疗前、治疗后3、6、12个月两组患者子宫体积、子宫内膜厚度、痛经、月经量、血清CA125及TNF-α变化情况。结果对照组患者异常子宫出血发生率高于观察组,差异有统计学意义(P<0.05)。观察组患者术后子宫体积无明显改变;对照组患者术后3个月体积明显缩小,6个月后稳定,两组术后比较,差异有统计学意义(P<0.05)。两组患者术后子宫内膜厚度均明显变薄,术后6个月基本稳定,两组间术后3个月、6个月及12个月比较,差异均无统计学意义(均P>0.05)。两组患者术后均出现明显痛经降级。两组患者术后3个月CA125及TNF-α水平均明显降低,术后6个月进一步降低,术后12个月与术后6个月相比下降不明显。结论依托孕烯皮埋剂可明显减少子宫腺肌病患者月经量,缓解痛经,与左炔诺孕酮宫内缓释系统效果相当,可作为子宫腺肌病患者的另一种选择。Objective To observe the clinical effect of etonogestrel subdermal implant in treatment of adenomyosis.Methods From January 2018 to January 2019,60 patients with menstrual change,dysmenorrhea,hysterauxesis,diagnosed as adenomyosis and treated by conservative treatment in Department of Gynecology,the First People’s Hospital of Nanning City were selected and randomly divided into observation group and control group,30 patients in each group.The patients in observation group were treated by etonogestrel subdermal implant from the first day to the fifth day of menstruation,the patients in control group were treated by levonorgestrel intrauterine sustained release system from the fifth day to the seventh day of menstruation.The uterine volumes,endometrial thicknesses,dysmenorrhea,menstrual blood volumes,serum CA125 and TNF-α before treatment,at 3,6,12 months after treatment in the two groups were observed.Results The incidence rate of abnormal uterine bleeding in control group was statistically significantly higher than that in observation group(P<0.05).After treatment,uterine volume didn’t change significantly in observation group;in control group,uterine volume decreased significantly after three months,which was stable after six months,there was statistically significant difference between the two groups(P<0.05).After treatment,endometrial thicknesses in the two groups thinned significantly,which were stable after six months,there was no statistically significant difference between the two groups(P<0.05).After treatment,dysmenorrhea was relieved significantly in the two groups.The levels of CA125 and TNF-α after three months in the two groups decreased significantly,which further decreased after six months,compared with the levels after 12 months,there was no significant difference.Conclusion Etonogestrel subdermal implant can significantly reduce menstrual blood volume,relieve dysmenorrhea,the effect is similar to levonorgestrel intrauterine sustained release system,which can be used as another choice for pa

关 键 词：依托孕烯皮埋剂 子宫腺肌病 痛经 左炔诺孕酮宫内缓释系统 

分 类 号：R711[医药卫生—妇产科学]